超声引导下射频消融术治疗原发性肝癌预后的相关因素分析
Analysis of prognostic factors on ultrasound guided radiofrequency ablation in the treatment of primary hepatic carcinoma
目的 探讨超声引导下射频消融术治疗原发性肝癌预后的临床疗效及相关因素分析.方法 回顾性分析2012年12月至2015年7月解放军沈阳军区总医院肝胆外科对130例肝癌患者行射频消融治疗的临床资料,总结成功随访的111例患者的临床治疗效果,并对预后相关因素进行分析.结果 随访患者的2年生存率,<2年生存率的比例为35.1%,≥2年生存率的比例为64.9%.单因素分析中,性别、年龄、有无肝炎、有无脾大或脾亢、术前谷草转氨酶、术前谷丙转氨酶、术前总胆红素及术前凝血酶原时间对患者的生存期无明显影响,差异无统计学意义(P>0.05);肝功能Child分级、有无肝硬化、血清白蛋白、甲胎蛋白、肿瘤数目、单个肿瘤最大直径及肿瘤最大直径之和对患者生存期有明显影响,差异有统计学意义(P<0.05).经多因素分析,单个肿瘤最大直径及血清白蛋白是影响肝癌患者射频消融预后的独立因素.结论 射频消融术是治疗肝癌的一种有效方法,因其治疗效果受多种因素的影响,通过对相关因素的分析,有助于选择更好的临床治疗适应证,同时提高肝癌的预后疗效.
更多Objective To explore the clinical efficacy and related factors on ultrasound guided radiofrequency ablation in the treatment of primary liver cancer.Methods This retrospective study involed the patients admitted between December 2012 and July 2015.A total of 130 patients who underwent radiofrequency ablation.111 of 130 patients were followed up.The clinical efficacy was summarized and the prognostic factors was analyzed.Results The survival rate of less than 2 years was 35.1%,the survival rate of more than 2 years was 64.9%.By the single factor analysis,gender,age,hepatitis history,splenomegaly or hypersplenism,preoperative aspertate aminotransferase,preoperative alanine aminotransferase,preoperative total bilirubin and preoperative prothrombin time were not obvious influence on survival,there was no statistically significant difference(P>0.05).Child grading,lcirrhosis of liver,liver function,serum albumin,alphafetoprotein,tumor number,a single tumor diameter and the total diameter of the largest influence on patient survival was statistically significant(P<0.05).By the multifactor analysis,the maximum diameter of single tumor and serum albumin were independent prognostic factors of radiofrequency ablation.Conclusion Radiofrequency ablation is an effective treatment for liver cancer,the treatment effect is influenced by many factors.Through the analysis of related factors,it is helpful to select a better indications for clinical treatment and improve the prognosis of hepatic carcinoma.
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